Dissertationen zum Thema „Administrations sanitaires“
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Morize, Noémie. „Les coûts de l’autonomie : économistes et médecins libéraux dans les réformes expérimentales des soins primaires“. Electronic Thesis or Diss., Paris, Institut d'études politiques, 2024. http://www.theses.fr/2024IEPP0009.
Der volle Inhalt der QuelleIn the primary care sector in France, “Multidisciplinary Primary Care Groups,” or MSPs, have progressively been introduced to enhance care coordination between self-employed healthcare professionals. These initiatives diversify the predominantly fee-for-service-based remuneration model within primary care, by adding publicly funded add-on payments for coordination efforts. Two pilot programs launched in 2019 sought to advance these reforms further, striving to increase care professionals’ accountability by providing financial incentives for reaching common health outcome goals for their shared patient groups. These initiatives were conceived by administrative executives trained in economics and received support from self-employed general practitioners. This doctoral study aims to explore the mechanisms behind the unlikely collaboration between general practitioners, traditionally known for their autonomy, and stakeholders seeking to reform the self-employed system in primary care.Through case studies involving qualitative data collection from 2019 to 2023, including observations and approximately one hundred interviews, the study reveals a group of stakeholders including administrative economists, researchers, and self-employed health professionals, advocating for these pilot programs and open to compromises to achieve their respective goals. Administrative economists adapt their strategies to maintain their relationships with practitioners, while some general practitioners, well versed in economic principles, seek to reorganize care accordingly. However, they also assert their central position in professional relationships
Gimbert, Virginie. „L'état sanitaire en question : les administrations à l'épreuve des risques“. Cachan, Ecole normale supérieure, 2006. http://www.theses.fr/2006DENSA004.
Der volle Inhalt der QuelleApollis, Benoît. „Autorisations sanitaires et hospitalisation privée : contribution à l'étude des autorisations administratives dans leurs rapports avec les personnes privées /“. Bordeaux : les Études hospitalières, 2008. http://catalogue.bnf.fr/ark:/12148/cb41243299z.
Der volle Inhalt der QuelleApollis, Benoît. „Autorisations sanitaires et hospitalisation privée : contribution à l'étude des autorisations administratives dans leurs rapports avec les personnes privées“. Montpellier 1, 2005. http://www.theses.fr/2005MON10038.
Der volle Inhalt der QuelleLeprêtre, Pascal. „Principe de précaution et droit sanitaire : cas français“. Paris 13, 2004. http://www.theses.fr/2004PA131028.
Der volle Inhalt der QuelleIn termes of the french law of 2 february 1995, the precautionary principle is that "according to wether the absence of certainty, considering technical and scientific knowledge of the moment, does not have to delay the effective and proportioned measure adoption, aiming to warn a serious and irreversible damage risk to the environment, to an economically acceptable cost". The thesis has for object to evaluate in the sector of the health, modes of application and the function of the principle of precaution, especially in its reports with the right of the health and more generally with the sanitary democracy. Become judicial principle of constitutional value, it contributes to delimit a new field of the right of the responsibility. The thesis tends to justify that the principal of precaution addresses to the collective and individual mastery of risks. Making this, this new forms responsibility will have to possess a conceived particular regime on the basis of a prejudice and causality risk, and will make place to a new makes justificatory, the social risk acceptability
Naud, François-Xavier. „L'État et la prévention sanitaire au dix-neuvième siècle“. Bordeaux 4, 2004. http://www.theses.fr/2004BOR40003.
Der volle Inhalt der QuelleTaleb, Ibrahimi-Ben Mansour Nafissa. „Les moyens administratifs de la politique de la santé en Algérie : réflexion sur le contenu d'une "révolution sociale"“. Montpellier 1, 1991. http://www.theses.fr/1991MON10031.
Der volle Inhalt der QuelleGnessien, Banou-Florence. „Réflexion sur les fondements d'une politique sanitaire dans un pays en développement : le Burkina Faso“. Perpignan, 1995. http://www.theses.fr/1995PERP0208.
Der volle Inhalt der QuelleSanitary conditions in burkina faso which is placed among the less advanced countries on earth, are not the most enviable. As a matter of fact, they result in a high mortality rate, especially among children, and by a low life expectancy, both things mainly due to low hygiene in the environment, to the lack of drinking water and to malnutrition. In any case, the observations which seemingly can be derived from these facts are : that the health policy implemented by the state of burkina faso, despite numerous efforts undertaken in this domain, still remains largely embryonic (first part of the thesis), and in the present context of economic crisis which has called for the drastics remedies of the fmi, the perspective does not seem to be any more optimistic. Unless a new approach to the health policy were to be considered (second part of the thesis), the watchword of the oms, "health for everyone by the year 2000", would still be a remote objective in burkina faso
Trullols, Segura Alberto. „Audit de culture organisationnelle dans un établissement catalan : cas de l'Institut municipal d'assistance sanitaire - I.M.A.S. - de la mairie de Barcelone“. Toulouse 1, 1995. http://www.theses.fr/1995TOU10027.
Der volle Inhalt der QuelleThe aim of the study is to define what are the explicative variables of job satisfaction of civil servants. The knowledge of the job expectations of this statutory personnel can be a means of contemplating a modernisation of the personnel function. A knowledge of the key factors of satisfaction helps us understand what are the barriers to modernisation of the personnel management in the public sector. Is the personnel satisfied by a statutory management or do they reject some of its empirical rules? To carry out this study an analysis of the main satisfaction determinants has been presented. On this basis a sui generis explicative model has been elaborated. It highlights four facets of satisfaction: work environment, job characteristics, qualitative gratifications, quantitative gratifications. This model has been tested with the help of the methodology of the human resources audit which helped, in a first phase go deeper into the model thanks to its exploratory phase. The statistical results show the necessity of focusing the analysis on the notion of intrinsic gratifications non specific to the public sector. A segmentation by professional levels (executives) proves pertinent. Besides, extrinsic factors that are proper to the sphere of public administration are also present, but their influence is weak
Mesnaoui, Abderrahmane. „Les bureaux municipaux d'hygiène au Maroc“. Montpellier 1, 1989. http://www.theses.fr/1989MON10020.
Der volle Inhalt der QuelleArgoud, Dominique. „La recomposition de l'action sanitaire et sociale depuis la décentralisation : l'exemple de la politique vieillesse en France“. Paris 1, 1995. http://www.theses.fr/1995PA010607.
Der volle Inhalt der QuelleDecentralization laws concerned especially the social sector. As a matter of fact, the recombining of decision-making channels, urged the different actors to replace them into the process, which has formalized new rules, old age policy is placed in the middle of those transformations. When removing the social action responsability to the departements, decentralization induces new regulation machineries, following a less vertical than sectorial method than before. It came of it local elderly policies quite flexible and able to adjust oneself to present developments of gerontologic secotr. As also old age policies are leading to vary according to referentials worked out by local actors
Nollet, Jérémie. „Des décisions publiques « médiatiques » ? : sociologie de l’emprise du journalisme sur les politiques de sécurité sanitaire des aliments“. Thesis, Lille 2, 2010. http://www.theses.fr/2010LIL20013/document.
Der volle Inhalt der QuelleAre public policies made by the media? This would-be influence of journalists over public decisions is common place among “decision-makers”. It is also assumed by Agenda-setting as well as social problems theorists. Yet, the real nature of the phenomenon is more complex: it follows different paths along several directions. It rests on the active and variable engagement of the politicians and high civil servants who produce decisions. Thus, the question needs to be rephrased: to what extent does the production of public decisions depend on the journalistic field? In order to elucidate this question, this doctoral thesis offers a sociological analysis of the specific logics which lead decision-makers (i.e. ministers’ personal staff, and representatives aswell as high civil servants,) to pay attention to media coverage in decision-making processes. The elaboration of this theoretical framework, at the crossroads of the sociologies of journalism and public action, is based on ananalysis of the handling of the mad cow disease by French officials during the 1990s. The ambition is to account for the very attention the holders of the executive power (namely, the Ministers of Agriculture, Consumption,Health, but also the Prime Minister and the President), the members of Parliament and high civil servants paid to media-related challenges within the practice of decision-making. Thus, it appears that the most “media dependent”decisions are the result of the handling of the most symbolic issues according to the logics of action of the most dependent agents on legitimization stakes in the journalistic field: the principal ministers and their advisers
Fellah, Lazhar. „Étude exploratoire du système de prévention algérien : déterminisme et problématique“. Bordeaux 4, 1998. http://www.theses.fr/1998BOR40038.
Der volle Inhalt der QuellePrevention in health care is not a glorious subject even though it is regularly mentioned in official speeches and seems to be of a great financial interest, so far as expenses for public health are concerned. In developing countries, the health care systems are copied from developed countries, without taking into account the pathologies of local populations. These systems are based on a curative approach where in the hospital is the main structure, consuming the most important share of the resources involved. This research analyses the algerian health care system of prevention in the ligth of economic theory. But prevention is an ambiguous concept and health too specific to be studied with the classical economic tools of supply and demand. In the first part of this work, we outline the exogenous factors in the determination of health states, the interest of a multidisciplinary approach of health cares problems going beyong the pure medical aspect (chapter i). Such an approach is different from the organization and functioning of a curative system (chapter ii). The second part is devoted to the problems related the elaboration, the coordination and evaluation of prevention programs which have some specific aspects in developing countries (chapter iii). It also presents the implementation of priority programs for particularly vulnerable groups of population, the development of information, education and the organization of a community participation in a strategy of health care promotion (chapter iv). The results of a program against tuberculosis show that a combination of preventive and curative appraoches can yield a good cost-efficiency ratio (chapter v)
Barlagiannis, Athanasios. „Hygiène publique et construction de l'Etat grec, 1833-1845 : la police sanitaire et l'ordre public de la santé“. Thesis, Paris, EHESS, 2017. http://www.theses.fr/2017EHES0044.
Der volle Inhalt der QuelleThis study is about the organization of public hygiene in the kingdom of Greece between 1833, when prince Otto of Bavaria ascends to the throne, and 1845, when the political and epidemiological frontiers of the kingdom are traced by a complete system of lazarettos and sanitary offices. We will firstly analyze the structures of sanitary prevention in the interior of the country (vaccinators, public health doctors, municipal doctors) as well as at its frontiers, and then we will focus on the measures against contagious diseases (such as the plague and smallpox) and against miasmas. We are also interested in examining the main diseases that determine the mortality of the period under scrutiny and the medical theories that explain the applicable sanitary measures. At the same time, we will review some of the aspects of the classical distinction of Erwin Ackerknecht between contagionism and miasmatic theory. Finally, we will study the difficult formation of an official group of medical professionals. The interest in public hygiene imposes the study of the biological construction of the state and, subsequently, of the state itself. Public hygiene defines the threats which it tries to prevent, and it creates and secures the collectivity. In the Police State of the cameralist king Otto, these developments are controlled by the bureaucracy, the administration, the public force and the science of medical police. Its purpose is to construct and order the public space, the space of state action, which is natural as well as social. This action of ordering imposes the centralization of health and at the same time it normalizes the natural elements and the social forces so that they can coordinate without resistance; in other words, the action of ordering pacifies. Medical police controls these processes by reconfiguring the ties that bind individuals with each other and with the geography, the nature and their diseases
San, Martino Laurence. „Les stratégies des collectivités locales en matière de délégation de service public. Le cas de la distribution de l'eau potable et de l'assainissement“. Montpellier 1, 2006. http://www.theses.fr/2006MON10003.
Der volle Inhalt der QuelleMoro, François. „L'administration du système de santé : les effets de la création de l'agence régionale de santé“. Thesis, Montpellier 1, 2014. http://www.theses.fr/2014MON10002/document.
Der volle Inhalt der QuelleThe administration of the health care system was deeply changed with the introduction of health agencies. The implementation of the ARS in 2009 contributes to unify the health action at the local level, what was missing under the influence of the ARH. The introduction of the ARS solely expresses a supposed simplification of the health care system, at the confluence of a classic health agency and of a local administration of the State. This new agency appears then as an unprecedented territorial agency what is proved by its intervention on the health care system. The appropriation of regulating instruments by this agency, which can be embodied in the contract, shows a renewal in health action. The ARS carries out a local regulation of health system which is original. This reform of health action is far away from being completed. Relationships between the ARS and public health institutions reveal this partial efficiency. The addition of functions awarded to the ARS harms the readability and the efficiency of its intervention on the health care system. The ARS has to be self-sufficient to become the main regulator of the health care system
Lenay, Olivier. „Régulation, planification et organisation du système hospitalier : la place des outils de gestion dans la conception des politiques publiques“. Paris, ENMP, 2001. http://www.theses.fr/2001ENMP1018.
Der volle Inhalt der QuelleCostin, Maria. „Qualité et modernisation du management hospitalier public, une comparaison Franco-Moldave des grands hôpitaux : Vers une réflexion stratégique de l'organisation hospitalière“. Paris 13, 2008. http://www.theses.fr/2008PA131007.
Der volle Inhalt der QuelleThanks to the new perspectives linked to the independence of 1991, the management of the health system is finally confronted to international norms. In spite of restricted means, the representatives for Moldovan health have to find modern methods of management, to ameliorate the quality of medical care. In France, the hospital reforms centered on the workmanship of the expenses of health and the modernization of the tools of management allowed to identify other problems such as: the quality and security of care, the rights of the patients and the content of the users. To better meet the needs of patients it is not enough to make important means available to the different medical services, but to bring about real efficiency for the patients. In this context, that amounts to bringing some change in the mode of administration of hospital business towards a culture of management where the research of performance becomes the rule. The improvement of the medical services passes through the modernization of the system of management. It is under conditions, that we are led to offer a managererial approach of 5 functions (organization of work, motivation, training, automatization and auto-evaluation) which structure the manager frame of hospitals, with regard to the complexity hospital activities. These 5 pillars will allow the managers to have a view of the tasks and priority missions to be fulfilled
Clavet, Michel. „Étude comparative des politiques publiques provinciales de santé, 1974-1993, quel est l'impact du politique sur les dépenses?“ Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0017/NQ48529.pdf.
Der volle Inhalt der QuelleAlam, Thomas. „Quand la vache folle retrouve son champ : une comparaison transnationale de la remise en ordre d’un secteur d’action publique“. Lille 2, 2007. http://tel.archives-ouvertes.fr/docs/00/40/54/39/PDF/ThAlam.pdf.
Der volle Inhalt der QuelleBased on a comparaison between France and Britain, the thesis studies a sectoral reform that would have been made compulsory after the 1996 BSE crisis. It shows how change is promoted in a policy sector (food safety) and how is contributes to its existence by enhancing its administrative legitimacy. Rather than taking change for granted, change is apprehended through its symbolic dimension, whose shaping highly depends on the struggles over the sector’s dominaion. The latter are an integral part of the crisis building, the policy timing (the rupture) and the nessity of change. Through a transnational brokers, it reasserts that the foreign reference is a weapon as well as an issue of national sectoral struggles. Far from a top down and uniform implementation of an international good practice, its translation is significantly filtered by the singularities of the domestic space
Carè, Rosella. „La sostenibilità della spesa pubblica : Il caso dei Piani di rientro del Sistema Sanitario“. Thesis, Paris, CNAM, 2014. http://www.theses.fr/2014CNAM0938.
Der volle Inhalt der QuelleThe objective of this thesis is to explore the theme of sustainability of public debt and public expenditure with an empirical focus on the Italian healthcare expenditure. Starting from a literature review, this work shows that sustainability have not an univocal and widely accepted definition and that macro economical point of view tend to prevail. At the same time the recent tension on public debt in European countries has highlighted the need of harmonized accountability systems capable to show the real level of public debt and public expenditure. The Italian healthcare system has represented a very interesting case to explore the effect of the implementation of an accrual system of accountability and the sustainability of public expenditure by the implementation of Healthcare recovery plan. This empirical analysis has been implemented by the use of a case study methodology. Results show that healthcare turnaround plan do not contain valid instrument of sustainability
L'obiettivo di questa tesi è quello di esplorare il tema della sostenibilità del debito pubblico e della spesa pubblica con un focus empirico sulla spesa sanitaria italiana. Partendo da una review della letteratura, questo lavoro dimostra che il concetto di sostenibilità non ha una definizione univoca e ampiamente accettata. Allo stesso tempo, le recenti tensioni sul debito pubblico nei paesi europei ha evidenziato la necessità di sistemi di contabilità armonizzati e capaci di mostrare il reale livello del debito pubblico e della spesa pubblica. Il sistema sanitario italiano ha rappresentato un caso molto interessante per esplorare gli effetti di un sistema di contabilità pubblica incentrato sul principio della competenza economica e, soprattutto, per testarne - nella pratica - le conseguenze sul livello della spesa sanitaria. In particolare, l'ultima parte di questo lavoro pone l'attenzione sul tema dei piani di rientro della spesa sanitaria italiana. L'analisi empirica, realizzata attraverso il metodo dello studio di casi multipli, mostra come i piani di rientro, nella loro attuale configurazione, non possano essere considerati validi strumenti non solo per il contenimento della spesa sanitaria e il rientro dal disavanzo ma, soprattutto, che non possono essere considerati strumenti operativi validi nell'ottica della sostenibilità
Vlassis, Ioannis. „Évolution du système de santé en Grèce : 1974-2008 : émergence et marginalisation récente d'une nouvelle structure administrative prometteuse“. Thesis, Montpellier 3, 2011. http://www.theses.fr/2011MON30005/document.
Der volle Inhalt der QuelleHealth System as a fundamental institution of the welfare state aids in securing and improving the level of welfare and quality of life of the population. The addressees are the members of or the whole community. Therefore, it is made clear that it is important to study the health policies and public administration, whose role is dominant. The content of the Health System, the administration models and the resources available define the policies of the states and are differentiated as opposed to the rest. The combination of welfare policies and the Health System is affected by the economical and social condition of each country. The longitudinal evolution of the Health System from 1974 to 2008 is the main pillar of our study. The subject will be approached through all the explanatory reports of the laws of the Greek republic. The primary sources will be processed and information related to the content of the study will be drawn. [...]
Rouanet, Léa. „Trois essais sur les progrès de la santé et le développement économique en Afrique“. Paris, EHESS, 2015. https://pastel.archives-ouvertes.fr/tel-01256681.
Der volle Inhalt der QuelleThe first chapter compares the colonial stratégies for health policies' provision and other colonial policies in former French West Africa. It gathers a unique dataset containing colonial inputs in health, éducation, public works and conscription. There was a very gênerai strategy as regards to the provision of colonial services, which had to do with investments' complementarity, returns to scale, the diseases' contagion risk and the demand for colonial services. The second chapter of this thesis looks at the relationship between adult height and under-five mortality in the context of the "double African Paradox" in West Africa. Africans are relatively tall in spite of extremely unfavorable disease environments. Moreover, their height stature decreased since the 1960's despite improving health conditions. A new model of height differential between survivors and deceased suggests that sélective mortality explains part of this paradox. Results imply that mortality sélection could be large enough to mask significant height increases. The third chapter develops a new indicator of gender préférences based on birth spacing, and applies it to Africa. Son preference is strong and increasing in North Africa, whereas Sub-Saharan Africa displays a preference for variety or no preference at all. Traditional family systems accurately predict the nature of gender preferences, while religion does not. Last, the magnitude of preferences is stronger for wealthier and more educated women
Mariotti, Ludovic. „La réforme "Hôpital, patients, santé et territoires" : Une recomposition de l’action publique locale en trompe l’œil ? : Une analyse par les instruments au prisme du secteur médico-social en région Provence-Alpes-Côte d'Azur“. Thesis, Montpellier, 2015. http://www.theses.fr/2015MONTD032.
Der volle Inhalt der QuelleThe 2009 reform “Hôpital, patients, santé, territoires” (HPST) made the « Agence Régionale de Santé » the leading health organism on a regional level. By using an instrument approach, our thesis exanimates the reality of this role during its application. This question echoes a more global issue: namely, who are health policies decided by, on a local level?By investigating the health field within the PACA region, through the lenses of the medico-social area, our work demonstrate that the instruments supposedly in the hands of the ARS are only barely so. Each instrument, whether it finds its origins in the old healthcare planning ideal or in a more liberal ideology, let us discover a distribution of competences different from what is legally intended
Renard, Laurence. „Valorisation des bases médico-administratives de l'assurance maladie pour identifier et suivre la progression d'une pathologie, en étudier la prise en charge et estimer l'impact de l'implémentation d'une politique de santé grâce à leur utilisation dans un modèle médico-économique : Application au diabète de type 2 au Luxembourg“. Thesis, Paris 5, 2012. http://www.theses.fr/2012PA05S004/document.
Der volle Inhalt der QuelleType 2 diabetes (T2D) is a chronic disease associated with many severe and costly complications. In a context of budgetary constraint, it is necessary to obtain an estimate the amount of resources to allocate to the management of chronic diseases. This includes monitoring the epidemiologic and economic evolutions. A database was built from medico-administrative databases of the national health insurance of Luxembourg. It included the healthcare consumptions associated with diabetes and its complications, of all type 2 diabetic patients treated in Luxembourg between 2000 and 2006. The objectives were to study the fields of use of this database and the possible applications for public health decision-making. This thesis gives some examples. In 2006, T2D prevalence in Luxembourg was 3.79% (N= 17070). An algorithm was built and permitted to identify three stages of diabetic nephropathy (3.77% of T2D cases in 2006). The analysis of the adherence to European follow-up guidelines showed a critical situation associated to several factors (treating physician, type of treatment, living region…). The mean costs associated with patients in dialysis were estimated at 116 647€/patient in 2006. Finally, a health-economic evaluation showed the dominance of a strategy promoting peritoneal dialysis in Luxembourg over the present situation
Jabot, Françoise. „L'évaluation des politiques publiques : cadres conceptuel et étude de son utilisation par les décideurs des institutions régionales de santé en France“. Thesis, Université de Lorraine, 2014. http://www.theses.fr/2014LORR0201/document.
Der volle Inhalt der QuelleContext: Despite the willingness showed in texts and procedures, evaluation in France is little integrated in the decision making process. However, in the health sector which faces multiple challenges, evaluation should be a useful approach to select choices. The use of evaluation depends on multiple factors such as, knowledge and its production process, characteristics of decision makers and others users, and the political and institutional context of the evaluation Objective: The objectives were: to assess the use of evaluation on health policies; to identify levers associated with use; to assess the capacity of evaluation to fit with decision-makers needs and to enhance usability. Method: Literature review allowed to enrich the understanding of the concept of use and to identify the main influent factors as well as the related issues. Regarding evaluation as a complex system, a model based on a systemic approach was built and tested in evaluations of regional public health plans (PRSP) in 4 steps: (1) global analysis of 16 evaluations; (2) relation process/use in on region; (3) use at short/medium term in 9 regions; (4) case studies and multicriteria analysis in 5 regions. Results: A first analysis enlighted the context and the contribution of the PRSP to the coherence of regional policies. A deeper process analysis carried out in one region pointed out the relation between final aims, management and evaluation use. The examination of evaluation consequences conducted in nine regions identified different forms of use and the major factors associated with them. The dynamic of change has been apprehended as a whole through the interactions between context, users and evaluation in five regions. Discussion: The effects of evaluation are more obvious in terms of knowledge building and evolution of practice than in radical change of policies. Context, evaluation credibility, actors’ commitment and motivation are key factors. Future research should help to better understand how to foster the culture and the capacities of evaluation. These are important prerequisites to a wider use of evaluation
Santin, Gaëlle. „Non-réponse totale dans les enquêtes de surveillance épidémiologique“. Thesis, Paris 11, 2015. http://www.theses.fr/2015PA11T007/document.
Der volle Inhalt der QuelleNonresponse occurs in most epidemiologic surveys and may generate selection bias (which is, in this case, a nonresponse bias) when it is linked to outcome variables. In epidemiologic surveillance, whose one of the purpose is to estimate prevalences, it is usual to use survey sampling. In this case, unit nonresponse occurs and it is possible to use methods coming from survey sampling to correct for nonresponse. Nonresponse bias can be expressed as the product of the inverse of the response rate and the covariance between the probability of response and the outcome variable. Thus, two options are available to reduce the effect of nonresponse. The first is to increase the response rate by developing appropriate strategies at the study design phase. However, the maximization of the response rate can prompt other kinds of bias, such as measurement bias. In the second option, after data collection, information associated with both nonresponse and the outcome variable, and available for both respondents and nonrespondents, can be used to calculate corrective factors. This solution requires having information on the complete random sample (respondents and nonrespondents); but this information is rarely sufficient. Recent possibilities to access administrative databases (particularly those pertaining to health insurance) offer new perspectives on this aspect.The objectives of this work focused on the nonresponse bias were to study the contribution of supplementary data (administrative databases and complementary survey among nonrespondents) and to discuss the influence of the response rate on the nonresponse error and the measurement error. The analyses focused on occupational health epidemiologic surveillance, using data (at inclusion) from the Coset-MSA cohort pilot study. In this study, in addition to the data collected by questionnaire (initial and complementary survey among nonrespondents), auxiliary information from health and occupational administrative databases was available for both respondents and nonrespondents.Results show that the data from the initial survey (response rate : 24%), corrected for nonresponse with information directly linked to the study subject (health and work) produce estimations of prevalence close to those obtained by combining data from the initial survey and the complementary survey (response rate : 63%), after nonresponse adjustment on the same auxiliary information. Using a complementary survey to attain a maximal response rate does not seem to be necessary in order to decrease nonresponse bias. Nevertheless, this study highlights potential measurement bias which could be more consequential for the initial survey than for the complementary survey. The specific study of the trade-off between nonresponse error and measurement error shows that, for the studied variables and after correction for nonresponse, the sum of the nonresponse error and the measurement error is equivalent in the initial survey and in the combined surveys (initial plus complementary survey). This work illustrated the potential of administrative databases for decreasing the nonresponse error and for evaluating measurement error in an epidemiologic surveillance survey
Bouzillé, Guillaume. „Enjeux et place des data sciences dans le champ de la réutilisation secondaire des données massives cliniques : une approche basée sur des cas d’usage“. Thesis, Rennes 1, 2019. http://www.theses.fr/2019REN1B023/document.
Der volle Inhalt der QuelleThe dematerialization of health data, which started several years ago, now generates na huge amount of data produced by all actors of health. These data have the characteristics of being very heterogeneous and of being produced at different scales and in different domains. Their reuse in the context of clinical research, public health or patient care involves developing appropriate approaches based on methods from data science. The aim of this thesis is to evaluate, through three use cases, what are the current issues as well as the place of data sciences regarding the reuse of massive health data. To meet this objective, the first section exposes the characteristics of health big data and the technical aspects related to their reuse. The second section presents the organizational aspects for the exploitation and sharing of health big data. The third section describes the main methodological approaches in data sciences currently applied in the field of health. Finally, the fourth section illustrates, through three use cases, the contribution of these methods in the following fields: syndromic surveillance, pharmacovigilance and clinical research. Finally, we discuss the limits and challenges of data science in the context of health big data
Djoulah, Farida. „Les personnes handicapées vieillissantes : enjeux socio-économiques, organisationnels, et diagnostics : le cas du syndrome de Down“. Thesis, Bordeaux, 2015. http://www.theses.fr/2015BORD0003.
Der volle Inhalt der QuellePeople with Down syndrome (DS), also known as trisomy 21, have seen their life expectancy increase beyond 50 years inducing the onset of AlzheimerOtype dementia (DTA). The consequences of this increase in life expectancy are multiple: difficulty of diagnosing dementia in a population with intellectual disabilities, difficulty of care for this population, etc. Thus, specialised institution and memory clinics remain powerless against the management and diagnosis of this population. Our thesis has aimed to address all the challenges related to this issue.Our work thus highlighted: 1 / this problem concerns both for the elderly than for the disabled, 2 / there is a real difficulty in diagnosing the presence of dementia in this population. To meet this challenge we have developed and tested a diagnostic aid tool. 3 / diagnostic problematic, professional training and support for people in charge of this population (activities, unsuitable premises, insufficient teacher ratio, increasing medicalization, etc.) via organizational modelling the life course of individuals suffering from SD and DTA. This model shows the impact on the evolution of organizations and host institutions and the lack of connection between the health sector and medicoOsocial. Hypothesis and possible solutions are discussed
Carré, Marie-Noëlle. „Gouverner la métropole par les déchets : Service urbain, action publique territoriale et écologie urbaine à Buenos Aires“. Phd thesis, Université de la Sorbonne nouvelle - Paris III, 2013. http://tel.archives-ouvertes.fr/tel-01054708.
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